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carbamazepine (carbamazepine, Elan / Bipotrol / Carbatrol)

✓ Approved

Shire · SCN1A · Small Molecule

What is carbamazepine?

carbamazepine is a small molecule developed by Shire. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand Namescarbamazepine, Elan, Bipotrol, Carbatrol
CompanyShire
Drug ClassSmall Molecule
Molecular TargetSCN1A, SCN2A, SCN3A
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Shire

Mechanism of Action

Molecular Targets

carbamazepine acts on 3 molecular targets:

SCN1Asodium voltage-gated channel alpha subunit 1 (DEE6B, FEB3)
SCN2Asodium voltage-gated channel alpha subunit 2 (Na(v)1.2, BFNIS)
SCN3Asodium voltage-gated channel alpha subunit 3 (Nav1.3, NAC3)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

carbamazepine is developed for 3 unique indications across 2 therapeutic areas.

Therapeutic AreaConditionPhase
Nervous system disordersEpilepsy✓ Approved
Nervous system disordersTrigeminal neuralgia✓ Approved
Psychiatric disordersBipolar disorder✓ Approved

Related Research Articles

PubMedBritish journal of pain2026-10-12

Trigeminal neuralgia management: What are patients saying?

Grafton Paige P, Lew Kylie K, Ranalli Carlotta C, Sharma Krish K et al.

Social media offers a window into how patients with trigeminal neuralgia (TN) discuss and interpret information about treatment. We performed a qualitative analysis of publicly available posts from Reddit to characterize patient perspectives on the platform and identify potential educational gaps in TN management. Posts published between September 2, 2020, and August 15, 2025, were collected using the Python Reddit API Wrapper and coded manually for treatment, purpose (question or informational), topic, poster perspective (patient or caregiver, pre- or post-treatment), and sentiment. Among 3,627 posts, 39.3% (n = 1,424) discussed medications and 60.7% (n = 2,203) addressed surgical treatment. Surgical discussions focused on microvascular decompression (53.3%) and stereotactic radiosurgery (26.7%), with percutaneous procedures rarely mentioned (8.5%). Carbamazepine (50.4%), oxcarbazepine (16.2%), and gabapentinoids (gabapentin 14.3%; pregabalin 10.8%) were the most frequently referenced medications. Overall, 1,019 posts were questions, primarily about surgery (n = 703) and commonly by patients prior to intervention (44.2%) inquiring about outcomes (57.6%) and candidacy (28.6%). Medication questions (n = 316) were typically from users already receiving treatment (71.2%) and most often addressed side effects (40.8%) or use (32%), including dosage and drug interactions. Sentiment differed significantly between treatment types, with surgical-related posts having a higher proportion of positive sentiment (χ2 2 = 328.1, p < 0.001). Overall, patients use social media throughout the course of TN treatment to seek guidance, share experiences, and clarify management options. Limited discussion of percutaneous procedures suggests gaps in public awareness, while uncertainty about surgical eligibility highlights opportunities for improved patient education. Additionally, the predominance of negative sentiment toward medications compared with surgery on social media forums may influence treatment preferences.

PMID 42861001
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PubMedLiver international : official journal of the International Association for the Study of the Liver2026-10-12

Drug-Induced Ductopenia in Two Prospective Registries: Favourable Outcomes and Late Recovery Despite Prolonged Cholestasis.

Bessone Fernando F, Hernandez Nelia N, Schinoni Maria Isabel MI, Brahm Javier J et al.

Drug-induced ductopenia (DID) represents a rare histological phenotype of drug-induced liver injury (DILI), typically associated with prolonged cholestasis and historically linked to poor outcomes. This study aimed to characterize the clinical presentation, histological features and outcomes of DID using data from the two prospective DILI registries. Liver biopsy was performed in 298 patients from the Spanish DILI Registry and the LATINDILI Network. Ten cases (3.4%) fulfilled histological criteria for DID, defined as absence of interlobular bile ducts in more than 50% of portal tracts. Clinical characteristics, biochemical parameters, histological features and outcomes were analysed and compared with those of non-ductopenic DILI cases. Patients with DID had a mean age of 47 ± 18 years, and 50% were female. Mixed liver injury predominated (50%). Causative drugs included amoxicillin-clavulanate, ciprofloxacin, carbamazepine, sertraline, ibuprofen, droxicam, captopril, metformin, ticlopidine and stanozolol. All DID cases had jaundice, and rash was more frequent (40%) compared with 9.4% in non-ductopenic DILI patients (p = 0.013). Total bilirubin was significantly higher in DID (median 12 mg/dL vs. 6.6 mg/dL in non-ductopenic DILI patients; p = 0.027). Histology revealed bile duct loss accompanied by cholestasis, portal inflammation, ductular reaction, fibrosis and occasional interface hepatitis. Despite marked cholestasis, no deaths or liver transplantation occurred in DID cases and biochemical recovery was achieved in most patients. Median follow up was 156 and 116 days in patients with DID and non-ductopenic DILI cases, respectively. DID is an uncommon phenotype of DILI, characterized by marked hyperbilirubinemia and a frequent association with hypersensitivity features. Most cases exhibited moderate liver injury and followed a benign, reversible clinical course, with no reports of poor outcome. However, delayed recovery was observed in a subset of patients.

PMID 42860753
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PubMedTalanta2026-10-11

Ex vivo SPME-LC-MS/MS determination of carbamazepine in tissues of Arctic marine bivalve Chlamys islandica.

Leszczyńska Dagmara D, Roszkowska Anna A, Lipiński Marcin M, Lisowska Julia J et al.

The Solid-Phase Microextraction (SPME) is a minimally invasive extraction technique that has gained interest in environmental studies. In this paper, we developed an SPME-LC-MS/MS protocol under ex vivo conditions to extract carbamazepine (CBZ) and its main metabolite, carbamazepine-10,11-epoxide (CBZE) from Chlamys islandica solid tissues. Optimization of SPME included selection of the stationary phase, desorption solution, desorption and extraction times. Under optimized conditions, we utilized commercially available C18 fibers, a 10 min static extraction and a 10 min desorption of CBZ and CBZE performed into 50 μL of ACN:H2O (80:20, v/v) mixture. The linear range for CBZ was 2.5-20 ng g-1 of wet mass with R2 = 0.9900; for CBZE, the linear range was 20-1000 ng g-1 of wet mass (R2 = 0.9743). LLOQ levels were 2.5 ng g-1 and 20 ng g-1 of wet mass for CBZ and CBZE, respectively. A 7-day exposure experiment was performed as a proof-of-concept, in which bivalves were exposed to CBZ at 1000 ng L-1. Ex vivo SPME enabled CBZ quantification in all four tissues. Mean concentrations increased from day 1 to day 7 in muscle, gonads, and the digestive system, while remaining stable in gills. Similar temporal trends were observed using solid-liquid extraction (SLE), although lower concentrations were obtained. The results demonstrate that SPME enables rapid and minimally invasive determination of pharmaceuticals in marine organisms and represents a promising approach for future in vivo monitoring of contaminant bioaccumulation.

PMID 42858742
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PubMedJournal of pharmaceutical sciences2026-10-11

Are we selecting the right model compounds for advanced formulation research?

Solymosi Tamás T, Kumar Dalip D, Urich JesúsAlbertoAfonso J, Hörmann-Kincses Theresa T et al.

Numerous advanced-formulation papers begin with the same problem statement: "30-40% of marketed drugs, 70-75% of clinical candidates and 90% of new chemical entities are poorly soluble in water". However, these figures are not fully supported by data and citations. We traced these numbers back to their original sources and reassessed them against the current API landscape. The 30-40% value was derived from a 2006 analysis of top selling drugs. Reassessing the top selling drugs in 2025 reveals a marked increase: about 55% of the orally administered small molecules now fall into the practically insoluble category. The 70-75% and 90% claims could only be traced to conference presentations and a review abstract with no underlying data. We further argue that the Biopharmaceutics Classification System categorization is not an intrinsic property of an API since it shifts depending on dose, particle size and formulation, i.e., no compound can be classified without considering the formulation and dose. A Scopus analysis showed that the APIs most frequently used as poorly soluble model compounds are the NSAIDs, antifungals and compounds, such as carbamazepine, carvedilol and simvastatin. The majority of these "poorly solubles" are in fact completely absorbed in vivo with no solubility issues at all. As more relevant alternatives to the above-mentioned compounds, we propose and briefly review ten marketed non-oncology APIs with unresolved dissolution and solubility limitations that would make better model compounds for advanced formulation research.

PMID 42858824
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PubMedHealth science reports2026-10-11

Assessment of Knowledge and Attitudes Toward Potential Drug-Drug and Drug-Food Interactions and Associated Factors Among Health Care Professionals at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A Cross-Sectional Study.

Mitku Melese Legesse ML, Anagaw Yeniewa Kerie YK, Dagnaw Abera Dessie AD, Geremew Derso Teju DT et al.

The increased likelihood of potential drug-drug interactions (PDDIs) and food-drug interactions (FDIs) is primarily attributed to the increasing use of multiple medications and the practice of taking medicines with food. Healthcare professionals' (HCPs') knowledge and attitudes toward PDDIs and FDIs play a critical role in ensuring patient safety and effective medication management. An increase in PDDIs and FDIs can compromise patient safety, decrease treatment efficacy, and increase healthcare costs. Therefore, this study aimed to assess the knowledge and attitudes toward PDDIs and FDIs, as well as associated factors, among HCPs at the University of Gondar Comprehensive Specialised Hospital. A cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital. Healthcare professionals' knowledge of PDDIs and FDIs was assessed using a self-administered questionnaire. To examine knowledge predictors, we conducted a regression analysis. Data analysis was done using SPSS version 27. There were 328 HCPs involved in this study; 325 completed the study, with a 99.1% response rate; n = 3 were excluded due to declining participation or unavailability during data collection. For acetaminophen, codeine, and amoxicillin, the HCPs' PDDIs knowledge levels were 219 (67.4%), whereas 66 (20.3%) were for carbamazepine and cimetidine. Regarding the FDI-related questions, HCPs answered items most frequently correctly on patients taking sulfa drugs with folate-containing foods (251; 77.2%), followed by patients taking antibiotics who should avoid acidic foods such as citrus juice (245; 75.4%). Multivariable analysis revealed that being trained as a pharmacists: AOR: 13.222, 95% CI: 6.785-30.769; medical doctors: AOR 11.265, 95% CI: 8.205-14.960; and age > 40 years: AOR 12.673, 95% CI: 1.875-85.646 were significantly associated with HCPs' knowledge of PDDIs and FDIs. Based on the results of this study, a minority of HCPs demonstrated good knowledge of potential drug-drug interactions (30.5%) and food-drug interactions (32.0%), indicating notable gaps in knowledge.

PMID 42857369
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PubMedFrontiers in pharmacology2026-10-11

Insights into osteoporosis triggered by common antiepileptic drugs via network toxicology, molecular docking and molecular dynamics simulations.

Wang Chunpeng C, Gao Siyang S, Wu Minjie M, Liang Bo B et al.

Antiepileptic drugs (AEDs), first-line treatments for epilepsy and related seizure disorders, are increasingly recognized as important risk factors for osteoporosis. However, the molecular mechanisms and specific targets underlying AED-induced bone loss remain largely unclear. We explored these mechanisms using an integrated strategy combining network toxicology, molecular docking, molecular dynamics simulations, and in vitro experiments. Common targets of four AEDs and osteoporosis were identified through database screening, followed by protein-protein interaction network construction, hub gene identification, and functional enrichment analysis. Molecular docking was used to evaluate the predicted binding affinity between AEDs and primary hub targets, and 100-ns molecular dynamics simulations were applied to assess dynamic binding stability. Furthermore, colony formation assays and Western blots were performed in MC3T3-E1 pre-osteoblasts to support the computational predictions. We identified 47, 50, 46, and 48 potential osteoporosis-related targets for carbamazepine phenobarbital phenytoin (PHT), and valproic acid respectively. These targets were mainly enriched in key signaling pathways and cellular processes associated with bone metabolism. Topological analysis identified four primary hub targets: epidermal growth factor receptor, CASP3, peroxisome proliferator-activated receptor gamma, and PTGS2. AEDs and their targets exhibited favorable binding affinity in the molecular docking simulations (binding energy < -5 kcal/mol). Molecular dynamics simulations revealed heterogeneous dynamic stability among the complexes: PB-CASP3 and PHT-PPARG reached relatively stable conformational equilibrium, whereas CBZ-EGFR displayed notable protein residue flexibility in the equilibrated trajectory, and VPA-PTGS2 sustained persistent structural fluctuations during the simulation period. In vitro experiments demonstrated that all AEDs inhibited the clonogenic capacity of MC3T3-E1 cells, and Western blot results further indicated that AEDs differentially modulated the expression and activation levels of their corresponding primary hub targets, which was consistent with the computational predictions. This study constructs an integrated research framework combining computational prediction and in vitro validation to explore potential molecular mechanisms underlying AED-induced osteoblast dysfunction and osteoporosis. The findings highlight candidate targets and provide a preliminary mechanistic basis for future rational clinical medication and skeletal protection in patients receiving long-term AED therapy.

PMID 42857104
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